Syringe type pump

ABSTRACT

In a syringe type pump with a barrel ( 2 ) and a piston ( 4 ) movable in the interior of the barrel the barrel has the shape of a segment of a toroidal tube ( 2 ) and the piston is moved by means of a driving rod ( 6 ) which is guided and supported by the inner surface of the barrel wall. By the toroidal shape the overall size of the pump is significantly reduced and by guiding and supporting the driving rod of the piston by the inner surface of the barrel wall intrinsic problems of tightness, stick-slip phenomena and blockage are solved. A device for injecting fluid into a patient&#39;s body or removing body fluid therefrom is using a syringe type pump with a toroidal barrel and a driving rod of the piston guided and supported by the inner surface of the barrel wall.

The present invention is related with a syringe type pump according tothe preamble of claim 1.

One major field of application for this type of pumps is the injectionof physiologically active fluid into a patient and/or the extraction ofbody fluid for diagnostic purposes. For this use the pumps are usuallyequipped with both a contact surface for attaching to a patient's skinand a cannula for the access to the patient's tissue or vessels forintroducing an injection fluid or the removal of analysis fluid.

Injection devices are widely used in patient care but their size andcomplexity largely restricts their use to specialized facilities.Recently, ambulatory use of injection devices has been pioneered indiabetes care for the delivery of insulin. To achieve the necessaryprecision of delivery these injection devices typically use syringepumps. The size of these devices is considerable, dictated mainly by theextended, longitudinal shape of a filled syringe with the drawn-outpiston, and necessitates their wearing attached to e.g. a belt orunderwear and they operate with connective barrels to a subcutaneouslyplaced cannula leading to inconveniences and safety problems.

More recently, because of these drawbacks, infusion devices which can beattached directly to the skin, preferably without long barrelsconnecting to the subcutaneous delivery cannula are being developed. Dueto the necessary reduction in size and weight the precise syringe-typepumps with sufficient volume of injection fluid are difficult to useattached directly to the skin. Therefore, alternative pump types withconsiderable drawbacks in precision and reliability of delivery underthe highly variable environmental and physiologic conditions encounteredduring real-life operation have been incorporated, e.g. delivery from areservoir with peristaltic pumps, with piston pumps using valves, or bysqueezing a flexible container. Syringe pumps for such applications havebarrels with a wide diameter in order to avoid an extended longitudinalfootprint, but this solution has disadvantages necessitating highdriving forces to inject against a considerable tissue back-pressure andmost importantly because of the risk of air bubbles entering andoccluding the injection cannula due to almost unavoidable relativelylarge dead-volumes, and unintended, relatively large bolus injectionsdue to stick-slip effects.

An appealing solution to reduce the footprint of syringe-type pumps withappropriately narrow barrels is to use an arcuate barrel as describede.g. by M. P. Loeb and A. M. Olson in U.S. Pat. No. 4,525,164, filed in1981. In spite of the attractiveness of this concept for precisepatch-type infusion pumps, conversion to safe and cost-effective medicalproducts is not evident, due to considerable practical difficulties inmanufacturing such toroidal syringe pumps with the necessary performanceat adequate costs. Obviously, such products have to use for theproduction of the arcuate barrel plastics-technologies with inherentsignificant tolerance margins because of differences in shrinkage. Sincee.g. the mandrel of the injection molding tool has to be removed by arotary motion and differences in shrinkage of the proximal and distalwall of the torus takes place thereafter, the resulting deviation froman ideal circular shape can not be easily corrected by adapting thetooling accordingly. The almost unavoidable deviation from an idealcircular shape for the manufactured torus and the deformations underhigh forces necessary to overcome high tissue back-pressure leads toproblems in achieving a sufficient sealing with the piston at reasonablefriction and avoiding sticking due to the not perfect fit between thearc of the barrel and the rotary movement of the rigid arcuate drivingrod of the piston. These difficulties get even more pronounced at lowbarrel diameters required for precise syringe-type pumps e.g. forinsulin delivery. Despite several more recent descriptions of arcuatesyringe pumps, e.g. by R. Paul Mounce et al. in WO 2008/024812 A2 or byO. Yodfad et al. WO 2008/139458 A2 this problem has not been adequatelyaddressed and no practical solutions are obvious from the descriptionsor figures.

The aim of the present invention is to provide an arcuate syringe typepump which avoids the disadvantages of the state of the art devices.

According to the invention this is achieved by the characterisingfeatures of claim 1.

The configuration using a curved toroidal barrel combines the highprecision of syringe pumps with a compact shape. In order to achieve anoptimal fit between barrel and piston throughout its entire move alongthe axis of the barrel the driving rod of the piston is guided andsupported by the surface of the inner barrel wall and is preferablyflexible and thus self-adapting to the inner curvature of the barrel.The barrel has a curvature preferentially with an arc below 180°,150°-160° being most preferred for an optimal length/diameter ratio ofthe barrel for precision of dosing and which can be manufactured bystandard plastics-technologies. Further, with improved individualcomponents of the device and the co-operation of the components adesired reduction in overall size and simplification of mechanicaloperation is achieved. According to the invention, major problems withcurrent devices are solved by an injection or analysis fluid removaldevice having the features disclosed herein below.

The subject injection device for introducing an injection fluid into apatient through the patient's skin or through an intravenous orintraperitoneal port comprises a syringe-type pump with a barrel in formof a segment of a toroidal tube and a piston fitting tightly into thebarrel which can be passed through the entire barrel actuated by driveand control means. The piston is moved by a driving rod which is guidedand supported by the inner wall of the barrel and is preferably flexibleand by this self-adapts to the curvature of the barrel without thedanger of sticking due to non-perfect fit between the arc of the barreland the arc of a stiff driving rod of the piston. In addition, thisconfiguration is adaptable to both, delivery of fluid with the rodpushing the piston, being guided by the distal inner surface of thebarrel and to withdrawal of fluid with the rod pulling the piston, beingguided by the proximal inner surface of the barrel. The device has acontact surface for contacting a patient's skin or an intravenous port.Typically, the contact surface to the skin is coated with an adhesiveand the syringe pump is linked to a cannula having a tip which isconfigured and dimensioned for piercing the patient's skin or a septumof a port and introducing an injection fluid into the patient orremoving analysis fluid.

In preferred embodiments, the inventive device has a cannula which isfixedly positioned relative to a casing and to the syringe pump. Theinsertion mechanism of the cannula into the patient's skin comprisespreferably a flexible contact surface adhering to the skin.

When used herein, the following definitions define the stated term

Adhesive contact surface for temporary wearing on the skin is made ofmaterials with strong adhesive properties, stretchability and minimalallergenicity. This adhesive layer is fixed on the base of the deviceeither covering the entire surface or at least its central part leavinga free rim in such a way that it does not interfere with itsflexibility. Preferentially the surface of the adhesive layer which isfixed to the skin is significantly larger than its surface which isfixed to the flexible base of the device, leaving a rim which is notfixed to the flexible base. This can be accomplished e.g. by an adhesivelayer extending beyond the surface of the base of the device or,preferentially by using a shape for the adhesive surface to the skinsimilar to or only slightly larger than the surface of the flexiblesurface of the device but fixing it to the latter in such a way that anouter annular zone is not fixed to the base of the device. Such a designis described in EP0825882 for a medical device with a rigid base.

Analysis fluid is blood, interstitial fluid or dialysate having been incontact with interstitial fluid through a semi-permeable membrane.

Analyte means any endogenous or exogenous substance the concentration ofwhich can be used to diagnose the health, organ function, metabolicstatus, or drug metabolizing capacity of an individual. Examples ofendogenous substances are glucose, lactate, oxygen, creatinine, etc.Examples of exogenous substances are drugs, metabolites of such drugs,diagnostic substances (e.g. inulin) etc.

Component with a flexible surface is made up of a casing which haspreferentially a circular or oval footprint and which has a flexiblebase. This base plate is constructed in such a way that it can bedeformed to a convex shape with a protruding part e.g. like a cone or agable (position 1). An additional feature of this base is that it canshoot from the convex shape into a flat shape (position 2) withsufficient velocity and force that this movement can provide the drivingenergy for implantation of the implantable parts of injection cannulasor diagnostic probes by pulling the skin attached by the adhesivesurface against the tip of the cannulas or diagnostic probes. Such aflexible surface can be achieved by appropriate segmentation of thesurface with hinge regions acting as springs and/or by using elasticmaterials with the necessary reversible stretching characteristics whichmoves e.g. from a pre-stressed shape to adopt a flat, relaxed shape.

Means to position the flexible surface relative to the implantable partsof injection cannulas or diagnostic probes in two defined positionsconsists of elements which can bring about the deformation of theflexible surface to a convex, pre-stressed shape and allow a rapidrelease from this position to adopt a flat, relaxed shape in acoordinated way for the entire surface. This can be accomplishedpreferentially by several pin-shaped elements protruding from theflexible surface and pushing onto a sliding bolt mechanism, but otherconstructions using screws, ramps, levers etc. are also possible.

Such a component with a flexible surface can be manufactured byinjection molding of suitable plastics but also by using other materialslike steel, composite or ceramic materials, etc. The base of thiselement has an opening in form of a hole or slit, as opening for theimplantable parts of injection cannulas or diagnostic probes. Theimplantable parts of injection cannulas or diagnostic probes arepositioned axially to this base in such a way that in position 1 theyare entirely covered up, whereas in position 2 they protrude the base.

Delivery of injection fluid encompasses both relatively fast injection(bolus) and relatively slow introduction (also called infusion orinstillation) of a liquid into the body.

Diagnostic probe is the functional element for the determination ofanalyte concentrations and means, but is not restricted to, any analysisfluid removal and on-line analysis or sampling system. In case of amicro-dialysis system a dialysis membrane forms the interface betweenthe interstitial fluid and a dialysis fluid which is passed at the otherside of the membrane. In a preferred embodiment a micro-dialysis probeconsists of an outer and an inner barrel, covered at the implantable tipby a dialysis membrane. The inner barrel is connected to the pump whichdelivers the dialysis fluid and the outer barrel is connected to ananalysis or sampling system.

Drive and control means contains all necessary mechanical, electronicsand software elements for all necessary functions of the device like,but not limited to, moving the piston of the toroidal syringe pumpaccording to internal or external signals, initiating, controlling andsurveying the correct functioning of the device, feeding and controllingthe diagnostic elements and transforming sensor signals into analytemeasurements, storing, displaying and transmitting analyte measurementsonline or batch-wise, interacting with external control devices,preferentially wirelessly, and giving warning signals if the device isnot functioning properly or if analyte measurements are not within apredefined range.

Driving rod of the piston has a construction providing a sufficientradial and axial flexibility to adapt to the actual curvature and axialposition of the toroidal barrel but exerting tangentially sufficientstiffness enabling precise movement of the piston within the barrel.Preferentially, the driving rod is flexible and its given formcorresponds closely to the arc of the toroidal barrel and a suitableplastics material is used for manufacturing in order to achieve analmost perfect adaptation to the actual form of the inner surface of thebarrel with small radial forces. Adaptation of the driving rod to theactual curvature and axial position of the toroidal barrel avoids thepossibility of detrimental blockage due to non-perfect fit between theaxes of the barrel and of a stiff driving rod.

The flexible driving rod has typically a contact brace allowinglow-friction contact with the inner surface of the barrel wall in itsmedian plane and a toothed rack engaging with a cogwheel of the drivemeans. Low-friction contact between the brace and the inner surface ofthe barrel wall is achieved by a suitable form and material.

The brace can be an integral part of the driving rod or be attached toit allowing the use of a different material with improved slidingproperties and in order to achieve the necessary radial and axialflexibility of the driving rod, the brace can e.g. have a segmentedstructure.

Another preferred construction replaces sliding contact by a rollingcontact to the inner surface of the barrel wall. Such a construction canhave e.g. a number of rolls connected by segments having sufficientflexibility at the hinge regions carrying the axes of the rolls to adaptto the curvature of the barrel.

The contact brace absorbs all radial force-components protecting thepiston sealing from these forces which can lead to substantial sealingdeformation resulting in problems with tightness and stick-slipphenomena up to piston blockage due to non-perfect fit between the axesof the barrel and of a stiff driving rod.

Typically at one end of the driving rod an end-piece in the form of thebarrel's cross-section but with slightly smaller diameter is rigidlyattached forming a face orthogonally centered relative to the barrel'scross-section by the brace, and transmitting the driving force from thedriving rod to the piston sealing tangentially to the axis of thebarrel. The piston with its sealing, e.g. an O- or an X-ring is fusedwith this end-piece or attached to it movably allowing centralself-positioning of the piston within the barrel. This can be achievedby a low-friction sliding surface between the end-piece of the drivingrod and the piston or by balls rolling at the interface and attenuatespossible problems arising from changes in the inner diameter of thebarrel along its axis.

Functional package is designed to hold the rigid part of the device by areleasable coupling mechanism and has a removable cap to protect theactive surface of the diagnostic probes during storage in a definedenvironment, such as humidity and allows maintaining sterility. Thefunctional package has also a rim element allowing, after removal of thecap, the correct attachment of the rim of the adhesive layer by pressingagainst the skin. Further, the functional package protects therelease/start mechanism of the device against premature, unintendedoperation and the release/start mechanism can be actuated only followingattachment of the device to the skin and removal of the functionalpackage.

Intravenous port comprises a catheter placed into a vein and having aconnective element, preferably a septum at the exterior end of thecatheter.

Sampling means is the functional element for collecting samples ofanalysis fluid for determination of analytes external to the device by,but not limited to biochemical, immunological, HPLC, or LC/MS/MSmethods. The samples can be collected in separated receptacles or in acontinuous cavity, e.g. a barrel or tube taking precautions that mixingof samples taken at different times is reduced to a minimum. This can beachieved e.g. by introduction of segments of air or of a non-misciblefluid into the analysis fluid creating separated samples in thecontinuous cavity.

Sliding bolt mechanisms adapts upon a circular or linear movementconsecutively several fixed positions and consists of elements whichdisplay a closed or open state, for example a solid surface or a hole.The movement of the slide mechanism is driven manually or for example bya spring actuated by a release element, for example through pressing orreleasing a button or handle, or through a turning movement. Forinserting in parallel a fluid delivery cannula and a flexible sensorwithin a guide needle into the skin by means of a component with aflexible surface attached to the skin, movement of the sliding boltmechanism from the storage position (position 1) to the next position(position 2) upon an easy manipulation actuates a rapid release of theflexible surface from a pre-stressed shape to adopt a flat, relaxedshape and inserts the fluid delivery cannula and the sensor guide needleinto the skin. The interim blockage of the sliding bolt mechanism atposition 2 is now released and allows to actuate the movement of thesliding bolt mechanism to the next position (position 3), which actuatesthe partial retraction of the guide needle.

In the following preferred embodiments of the invention are describedwith reference to the accompanying drawings in which

FIG. 1 is a diagrammatic sectional top view of an injection device witha circular syringe pump showing the principle of a circular syringe pumpaccording to state of the art construction but with an improved solutionallowing a limited adaptation of the piston to the curvature of thebarrel.

FIG. 2 is a diagrammatic sectional top view of a combined injection andanalysis fluid removal device with two circular syringe pumps accordingto an embodiment of the invention.

FIG. 3 is a diagrammatic cross sectional view of a syringe filling andan injection cannula insertion mechanism into the skin according to oneembodiment of the invention.

The injection device shown in FIG. 1 has a casing having a cylindricalside-wall 1 housing a barrel in form of a segment of a toroidal tube 2.One end 3 of the barrel is provided with a connecting channel to acannula (not shown). The barrel has a circular cross section.

A piston 4 is arranged in the interior of the barrel and is providedwith a seal fitting tightly at the inner wall of the barrel. The pistonis connected to a driving rod 6 which is circularly shaped for drivingthe piston through the entire length of the barrel.

Using established technologies for manufacturing of a toroidal cylinderthe fit between its curvature and the driving rod of the piston will notbe perfect. To correct for this the mechanism 5 disclosed hereconnecting the piston to the rod 6 allowing radial adaptation of thepiston represents an improvement as compared to the state of the artsolutions e.g. as described by M. P. Loeb and A. M. Olson in U.S. Pat.No. 4,525,164, using a resilient spherical piston which is slidablycontacted by a cupped distal end of a driving stem allowing it to rotatewithin the barrel, since such a construction has intrinsic problems ofsealing and friction.

At its end opposite the piston the driving rod has a perpendicularlybent arm 7 extending to a central pivot, thereby reducing the radialcomponent of the force and the resulting friction by moving the pistonthrough the barrel. The inner side of the rod has a gear rim 8 which isdriven by a gear drive 9. The gear drive is driven e.g. by a gear trainand an electrical motor (for example a watchwork drive) which can beregulated for controlled delivery by signals from inbuilt and/or remotecontrol elements (not shown in the figure). Alternatively, other drives,as known in prior art, can be employed.

Using standard manufacturing technologies for the toroidal barrel suchas e.g. plastics-technologies with an injection molding tool having amandrel which has to be removed by a rotary motion, deviations from aperfect circular shape and variations in its shape are unavoidable dueto inherent differences in shrinkage e.g. of the proximal and distalpart of the torus wall during manufacturing. Because of this almostunavoidable deviation from an ideal circular shape for the manufacturedtorus the exact geometric fit between the barrel and the driving rod ofthe piston moved by a rotary motion can not be secured. Even if thedriving rod of the piston is manufactured using steel-technologies witha high level of form-stability, the fit of the attached piston to thebarrel's shape along its longitudinal axis becomes variable. Indeed,e.g. a difference of only 2% between the radius of the barrel and of thedriving rod causes a serious relative shift which can lead to collisionbetween barrel wall and driving rod for torus arcs of e.g. 150°-160°which can be manufactured with standard technologies and are aimed at inorder to sufficiently reduce the footprint of the syringe-type pump. Inaddition, the plastics parts usually used to manufacture the housingholding the barrel and the guideways for the driving rod are notabsolutely rigid and can slightly deform especially under the appliedforces necessary to provide the pressures of several bar to overcometissue resistance. The resulting radial and axial forces to correct forthe actual shape differences between axis of barrel and driving rod canbecome very substantial with a rigid driving rod which is used forarcuate piston-drive mechanisms described so far. These forces have tobe absorbed by the sealing of the piston leading to its deformationcausing high friction with resulting stick-slip phenomena up to blockageand/or problems with tightness of the piston. Even if the piston canadapt slightly to correct for the deviation between the axis of thebarrel and of the driving rod as described in prior art and with theimprovement discussed and exemplified in FIG. 1 the worst case scenarioof blockage by clamping between the rigid driving rod and the barrelwall cannot be excluded. Therefore, for medical use of controlled andprecise fluid delivery constructions according to prior art in which adriving mechanism with a rigid driving rod is used to move the piston inan arcuate barrel are not sufficiently safe. These problems get evenmore pronounced at low barrel diameters required for syringe-type pumpsintended for the precise delivery of small volumes such as e.g. insulinfor diabetic patients.

According to the subject invention, the solution to avoid stick-slipphenomena and/or problems with tightness or even blockage of the pistonor clamping between the rigid driving rod and the barrel wall is to usea driving rod of the piston which adapts to the actual curvature of thebarrel, being guided and supported by the inner wall of the barrel. Incontrast to constructions described in prior art the rod guided andsupported by the inner wall of the barrel of the subject invention canadapt to all deviations from the ideal shape and geometry which areunavoidable using cost-effective manufacturing technologies andmaterials. A preferred embodiment of the subject invention, which can beadapted for both, fluid delivery and fluid withdrawal, is exemplified inFIG. 2.

FIG. 2 shows a combined injection and analysis fluid removal device withtwo independent circular syringe pumps in top view of a horizontalsection. The pump for delivery of injection fluid is shown in the moreperipheral part of the drawing, whereas in the more central part a pumpfor removal of analysis fluid is shown. In FIG. 2 parts corresponding toFIG. 1 are given the same reference numbers. The embodiment in FIG. 2does not have a rigid driving rod. Instead, the driving rod 6 of thepiston is formed in such a way that its movement is guided and supportedby the inner surface of the barrel wall as shown in cross section inDetail A. Importantly, a brace 11 of optimized form and material foreven movement with low friction to increase precision and to reduce thenecessary forces for piston movement forms the gliding zone betweendriving rod of the piston and inner surface of the barrel wall. This canbe achieved by using for the driving rod plastics with suitable glidingproperties or by attaching a rim of suitable material, e.g. a steelwire, but other possibilities of friction reduction like e.g. aconstruction with a number of rolls the axis of which is held by thebrace can be implemented in order to avoid gliding resistance andreplace it by rolling resistance.

The radial and axial flexibility of the driving rod exemplified inDetail A can be further increased e.g. by using a segmented structure ofthe brace holding glidingly a steel wire or the rolls or even aback-bone like structure of the flexible driving rod with segmentslinked by hinge regions. To ensure safe transmission of the power to thegear rim 8 to move the piston, the gear drive 9 is supported by aradially opposing brace 10, preferentially in the form of anantifriction bearing, pressing against the contact rim 11 of the drivingrod, but other constructions like e.g. a side-wall attached to thehousing are also possible.

The piston 4 with its sealing, e.g. an O- or an X-ring is held in adefined distance from the inner surface of the barrel wall by the braceof the driving rod and transmits only the tangential driving force tothe piston. In addition, to allow self-centering of the piston in thelumen of the barrel, in an alternative construction the piston is notdirectly fused rigidly with the end of the driving rod, but movablyattached to an end-piece of the driving rod which is held by the bracein a defined distance from the barrel wall. This can be achieved e.g. bya low-friction sliding surface contact between the end-piece of thedriving rod and the piston or by balls rolling at the interface. Such aself-centering construction might be useful to improve the performanceof the pump in case of significant manufacturing process derivedvariability in the inner shape and diameter of the barrel along itsaxis.

For delivery of injection fluid the driving rod of the piston ispushing, while guided and supported by the distal inner surface of thebarrel (shown in Detail A). In contrast, the circular syringe pump forremoval of analysis fluid is operated in suction mode and the drivingrod of the piston is pulling, guided and supported by the proximal innersurface of the barrel (mirror image of Detail A, not shown as detail). Aproximally located gear rim 8 to move the piston can also be used e.g.in a construction in which the gear rim is double-tracked and set backrespective to the brace 11 and the gear drive 9 has a slit toaccommodate the protruding brace.

FIG. 3 is the central part of a tangential cut of the device through theend portion 3 of the barrel. A first channel 15 is leading to the upperside of the device and is closed by a septum 14. For filling the barrelwith injection fluid a syringe (not shown) having a needle 13 is piercedthrough the septum 14. Before filling, the piston is touching the endportion 3 of the barrel (not shown). The injection fluid is introducedthrough channel 15, thereby pushing the piston towards the opposite endof the barrel.

A second channel 17 is leading from the interior of barrel 2 to aninjection cannula 16 for delivery of injection fluid into the skin. Thecannula 16 is closed at the other end with a septum-seal 18 which isheld in a housing 19. The overall construction is such that the deadvolume is minimal and no significant volume of air is in the systemafter filling with injection fluid.

In the exemplified embodiment the insertion means into the skin of thecannula 16 has a flexible base plate 20 which is attached to the skin byan adhesive layer 21. In the ready-to-use mode shown in the figure thisflexible base plate is deformed to a convex shape covering the cannula16. The base plate is preferentially annular or oval and in order toinsert a cannula which is remote from the center of the device consistspreferentially of two segments with a diagonal slit, forming a gableupon bending. This configuration allows also to use this insertion meansfor more than one cannula simultaneously which are positioned along thediagonal slit, e.g. if more than one infusion pumps for more than oneinfusion fluid is used and/or for the combination with insertion of adiagnostic probe into the skin. By the spring-type mechanism, inaddition the septum-seal 18 is pierced by the cannula before it entersthe skin. The segments are attached to the circumference of the casing 1by springy hinge regions and are in addition preferentially made of aflexible material. Alternative forms like a radial segmentation,preferably into 5 to 8 segments with a spacing between them and acentral opening, forming a cone upon central bending are also possibleif the cannula is placed close to the center of the device.

On its underside, the flexible base plate has an annular or ovaladhesive layer for securing the device to the patient's skin with adiagonal slit or a concentric central opening, respectively similar tothe base plate. This adhesive layer is composed of three parts, a gluefor fixing to the flexible base plate, a textile providing the necessaryflexibility and a glue for fixing onto the skin. Suitable materials withlow allergenicity potential are commercially available. The adhesivelayer can have a larger circumference than the device but it could havealso the same circumference if the attachment to the base plate leavesan outer zone where it is not connected to the housing.

Upon release of the pre-stressed base plate actuated e.g. by a slidingbolt mechanism (not shown) it rapidly relaxes to a flat shape towardsthe bottom of the housing of the device 1, pushes the housing 19 of theseptum-seal 18, and the cannula 16 pierces through the septum-seal 18and through the skin attached by the adhesive layer.

Upon reading this specification, various alternative embodiments willbecome obvious to the skilled artisan. For example, the drive means formoving the piston or the implantation mechanism of the cannula fordelivery of injection fluid into a patient, or for removal of analysisfluid of a patient could be achieved via numerous chemical, mechanical,or electrical means. Further, a large variety of diagnostic elements forthe online analysis or for sampling of analysis fluid for removedanalysis as well as control and measuring means can be accommodated withthe device.

The major advantages of a device with a toroidal syringe-type pumpdescribed above are its reduced footprint-size by which it can becomfortably worn and operated by the patient and at the same time theinherent high precision of a syringe type pump. The intrinsic problemsof such pumps exemplified in prior art of sealing, friction causingstick-slip phenomena, and even blockage caused by lack of exact fitbetween the actual form of the arcuate barrel and of the plungerunavoidable in manufacturing of the toroidal barrel and the device usingstandard cost-effective technologies are solved by using as the drivefor the piston a driving rod which is guided and supported by the innerwall of the barrel and therefore can adapt to all deviations from theideal shape and in geometry. A further advantage is the absence of theproblems with connecting tubings between a syringe pump and the cannulapenetrating the skin. In addition, the device according to the inventionhas almost no dead volume thus avoiding complicated mechanisms to moveair out of the system during filling of the pump with injection fluid.

1. A syringe type pump comprising a barrel curved in a shape of asegment of a toroidal tube with a lengthwise extending axis, aconnecting opening in a vicinity of one end of the barrel for thepassage of fluid, a piston movable along the axis and tightly fitting inan interior of the barrel, and a driving rod for reciprocally moving thepiston, the driving rod is guided and supported by an inner surface of abarrel wall.
 2. The pump according to claim 1 wherein the driving rod isflexible.
 3. The pump according to claim 1 wherein the barrel has acircular, elliptical, oval or angular cross-section.
 4. The pumpaccording to claim 1 to 3 wherein the flexible driving rod is guided andsupported by the inner surface of the barrel wall by means providing alow friction gliding contact.
 5. The pump according to claim 1 whereinthe driving rod is guided and supported by the inner surface of thebarrel wall by means providing a rolling contact.
 6. The pump accordingto claim 1 wherein control elements for the movement of the pistonaccording to integrated or remote control signals.
 7. A device forinjecting a fluid into a patient's body or retrieving body fluidtherefrom a pump comprising a barrel curved in a shape of a segment of atoroidal tube with a lengthwise extending axis, a connecting opening ina vicinity of one end of the barrel for the passage of fluid, a pistonmovable along the axis and tightly fitting in an interior of the barrel,and a driving rod for reciprocally moving the piston, the driving rod isguided and supported by an inner surface of the barrel wall.
 8. Thedevice according to claim 7 wherein the device is composed of a reusablepart comprising a drive means and control elements and a disposable partcomprising other elements.
 9. The device according to claim 7 whereinmeans for the filling of the barrel with fluid while moving the piston.10. The device according to claim 7 further comprising a cannulaconnected to the pump barrel for delivery of injection fluid.
 11. Thedevice according to one of claims 7 further comprising a cannula or adiagnostic probe connected to the pump barrel for removal of analysisfluid.
 12. The device according to claim 11 further comprising samplingmeans with a component for a controlled introduction of segments of airor of a non-miscible fluid into the analysis fluid to avoid mixing. 13.The device according to claim 7 further comprising more than onecircular syringe pump for delivery of injection fluid, for removal ofanalysis fluid, or for introduction of segments of air or of anon-miscible fluid.
 14. The device according to claim 7 furthercomprising an adhesive contact surface for contacting the patient's skinand adhering the device to the patient's skin.
 15. The device accordingto claim 10, further comprising means for inserting a part of thecannula or of the diagnostic probe into the skin.
 16. The deviceaccording to claim 15 wherein the cannulas or diagnostic probes arefixedly positioned relative to the barrel and the insertion means intothe skin is a component with a flexible surface with an adhesivesecuring adherence of that surface to the skin and means to position theflexible surface relative to the fixedly positioned cannulas ordiagnostic probes in such a way that in a first position these areconcealed by the surface and in a second position the implantable partsof them are exposed beyond the surface and a mechanism to bring thesurface from the first to the second position.
 17. The device accordingto claim 15 wherein the insertion means of the cannulas or diagnosticprobes into the skin actuates the piercing of protecting septums ofthese cannulas or diagnostic probes before insertion into the skin. 18.The device according to claim 9 further comprising means for connectingthe cannula or the diagnostic probe to an intravenous or intraperitonealport.
 19. The device according to claim 18 wherein the connecting meansof the device to an intravenous port comprises a port at the exteriorend of an intravenous catheter having a cavity with one or more septums,a coupling element having means for positioning and fixing the port andthe injection or blood sampling device relative to each other and havingan adhesive surface for securing onto the skin, and one or moreconnecting cannulas linking the injection or blood sampling device tothe port by piercing septums of the port introducing the injection fluidvia the intravenous port into the patient, or to allow removal of bloodvia the intravenous port.
 20. The device according to claim 19 whereinthe device contains at least two circular syringe pumps, one fordelivery of injection fluid into a patient and one for removal ofanalysis fluid, and both are connected in parallel to an intravenousport of a dual-lumen intravenous catheter, sharing the same connectingmeans.
 21. The device according to claim 7 further comprising measuringmeans for one or several analytes and means to display the results ofthese measurements and/or to transmit them wirelessly and/or to use themfor the controlled delivery of injection fluid.
 22. The device accordingto claim 7 further comprising means for securing adherence to the skinis an adhesive layer for temporary wearing on the body, and the adhesivelayer is fixed on the flexible surface of the device by a reducedsurface in comparison to the adhesive surface to the skin.
 23. Thedevice according to claim 16 wherein the means for bringing the flexiblesurface from a first to a second position makes use of the elasticity ofthis surface for a rapid movement by relaxation from an enforced tenseposition.
 24. The device according to claim 23 wherein the means forbringing the flexible surface into two distinct positions comprises asliding bolt mechanism actuated by pressing a knob.
 25. The deviceaccording to claim 7 wherein the device is applied to the skin using afunctional package with a rim pressing the adhesive layer towards theskin and protecting the release and actuation elements of the deviceagainst unintended activation.